Abstract:
Introduction: Non-adherence to the prescribed treatment regimen in patients with type 2
diabetes mellitus is quite high. Furthermore, it has been associated with higher rates of
hospital admissions, suboptimal health outcomes, increased morbidity and mortality, and
increased health care costs. The present systematic review study aimed to explore the
determinants that contribute to non-adherence to treatment among patients with type 2
diabetes mellitus in Kenya.
Methods: A systematic review of studies conducted in Kenya on the present research
problem published in English between December 2013 and May 2020. The databases
included Scopus, Web of Science, Science Direct, Cochrane Library, PUBMED, OVID
and Google Scholar. The following were the key words used in the search: “Nonadherence Diabetes Patients”, “Determinants of Non-adherence Diabetes Patients” AND
“Health Facilities” AND “Kenya”. Qualitative analysis was used to present data under
thematic domains.
Results: The search generated 17,094 articles of which only 15 met the inclusion criteria.
The major determinants were presented under three thematic domains: 1) Cost – income,
insurance, distance, bills of drugs and food; 2) Patient characteristics – perception of
(efficacy, severity, effects of non-adherence), knowledge, co-morbidity, family support, self
unfounded beliefs; and 3) Health system – health education, multiple drugs, evaluations and
support, guidelines, poor perception of system.
Conclusion: A multitude of factors including unaffordable care, patient’s poor knowledge
on the disease process, less family support in patient’s daily self-care management, complex drug regimen and unsatisfactory health messages from the health providers were observed to be associated with non-adherence. Implementing integrated care programs will help in reducing levels of non-adherence among type 2 diabetes mellitus patients.
